New criteria and guidelines for the diagnosis of Alzheimer’s disease have been published — for the first time in 27 years — by three expert workgroups spearheaded by the Alzheimer’s Association and the National Institute on Aging (NIA) of the National Institutes of Health (NIH).
Collectively the groups have expanded the definition of Alzheimer’s to include two new phases of the disease: (1) presymptomatic and (2) mildly symptomatic but pre-dementia, along with (3) dementia caused by Alzheimer’s.
These changes reflect the current belief that symptoms and changes in function have begun years or even decades before they are noticed or even diagnosed.
“It is our hope that incorporating scientific knowledge gained and technological advances made over the past quarter century will improve current diagnosis, bring the field closer to earlier detection and treatment and, ultimately, lead to effective disease-modifying therapies,” said William Thies, Ph.D., Alzheimer’s Association chief medical and scientific officer. “Development and publication of these articles is a major landmark in the field. That said, publication of these articles is not yet the end of the process of developing new diagnostic criteria for Alzheimer’s, but is another major step in the process.”
The proposed new Alzheimer’s disease diagnostic guidelines were published online today by Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. Hard copy publication is scheduled for the May 2011 issue.
The Key elements to the new diagnostic guidelines are:
- Update widely used existing guidelines for Alzheimer’s disease originally established in 1984 by the National Institute of Neurological Disorders and Stroke (NINDS) and the Alzheimer’s Association (then known as the Alzheimer’s Disease and Related Disorders Association).
- Refine existing guidelines for diagnosing mild cognitive impairment (MCI).
- Broaden the conceptual framework for thinking about Alzheimer’s disease to include a “preclinical” stage characterized by signature biological changes (biomarkers) that occur years before any disruptions in memory, thinking or behavior can be detected.
- Establish a framework for eventually adding biomarker benchmarks to the diagnosis of Alzheimer’s disease. The guidelines for MCI due to Alzheimer’s disease include specific biomarkers that may be used now in research settings, with the expectation that these recommendations are a work in progress that will evolve as knowledge advances.
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